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General NPI Number Information
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NPI Number | 1154659381
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Entity Type | Individual
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Provider Name | JULIUS EDWIN BUNEK II D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/30/2009
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 2715 PACKARD ST
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City | ANN ARBOR
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State | MI
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Zip | 48108-3336
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Country | US
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Telephone | 734-822-2200
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Fax | 734-822-2203
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Provider Business Mailing Address
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Address Line | 4806 LOHR RD
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City | ANN ARBOR
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State | MI
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Zip | 48108-5910
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Country | US
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Telephone | 734-678-4029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2901020091
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License Number State | MI
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